How we estimate ROI

What it measures.The cost avoided when employees choose a plan that actually fits their expected utilization instead of defaulting to the richest option or rolling over last year's election.

Inputs. McKinsey-cited research estimates $372 per employee per year in overpayment from suboptimal plan selection. Roughly 38% of that overpayment is recoverable at a midpoint assumption (split evenly between employee and employer savings). That gives us $140 PEPY.

Applies to: All plan types (fully insured and self-funded).

What it measures. The staff-time savings when employees stop routing basic benefits questions through HR.

Inputs. SHRM benefits-burden estimates put the load at roughly 3 hours per week per HR FTE, at $55/hour fully loaded, with 1 FTE per 80 employees. That works out to $30 PEPY.

Applies to: All plan types.

What it measures. The claims savings when outpatient surgical volume moves from hospital outpatient departments (HOPDs) to ambulatory surgery centers (ASCs), which typically reimburse at significantly lower rates.

Inputs. AJMC/RAND (October 2025) documents a roughly 110% cost differential between HOPD and ASC for comparable procedures. At a 5% shift (the calculator default), the midpoint estimate is $130 PEPY, derived linearly at $26 per percentage point. The calculator lets you adjust the shift between 2% and 15%. The linear assumption holds reasonably in that range but breaks down at the extremes.

Applies to:Self-funded plans only. Fully insured employers don't bear claims cost directly, so site-of-service savings flow to the carrier, not the employer.

What it measures.The net recovery to the employer from auditing medical claims for overpayments — duplicate charges, unbundled codes, incorrect provider reimbursements, and similar errors that slip through auto-adjudication.

Inputs.

• $15,000 average annual medical spend per employee (Source: KFF Employer Health Benefits Survey).
• 0.5% recovery rate of total medical spend via independent claims audit (Source: Healthcare Horizons — conservative low end of their published 0.5%–1% benchmark).
• 25% Compass contingency fee on recovered overpayments. Employer keeps 75% of recoveries net of fee.

Math. $15,000 × 0.005 × 0.75 = $56 PEPY net to employer.

Applies to:Self-funded plans only. Fully insured employers don't bear claims-overpayment risk directly — the carrier owns the claim and any recovery flows back to the carrier, not the employer.

Caveat. Recovery rates depend on plan size, TPA cooperation, claim age (most TPAs limit recovery to claims under 24 months), and findings mix. $56 is a midpoint and actual results will vary.

Adoption rate.The calculator bakes in a 35% adoption rate — the share of eligible employees who engage with Compass programming enough to change behavior. This is not user-adjustable. We use the midpoint of our observed range to keep the estimate honest.

Compounding is excluded. Each line is calculated independently. In practice, an employee who picks a better plan and shifts to an ASC generates more value than the sum of the two lines suggests. We leave that upside on the table rather than overstate.